NewsMakers
Autoclaving, alcohol not the best options for disinfecting, reusing face masks
The study found that neither sterilization in an autoclave nor alcohol treatment caused visible damages to the surgical masks. The 3M 8210 N95 respirator revealed physical damages after implementing a single autoclave disinfection such as partial disintegration of the soft sealing material around the nose clip, and, importantly, loss of strap elasticity, which made this respiratory protective device not reusable.
A University of Cincinnati researcher is advising against using two widely available sterilization methods to clean disposable surgical masks and N95 respirators for reuse in the midst of the coronavirus pandemic.
Scarcity of personal protection equipment in medical settings has led many health systems to consider sterilizing and reusing masks developed initially as disposable items, says Sergey Grinshpun, PhD, director of the University of Cincinnati Center for Health-Related Aerosol Studies and professor in the UC Department of Environmental and Public Health Sciences.
The Centers for Disease Control and Prevention (CDC) has allowed reuse of N95 facepiece respirators as a crisis capacity strategy.
Grinshpun tested two brands of N95 respirators along with two types of surgical masks — one with high filtration and one with low-filtration abilities — using an autoclave, an apparatus that works similar to a pressure cooker to sterilize items by using steam, heat and pressure during a specific time frame.
“The question for us was, what will happen with the performance of these N95 respirators and the surgical masks after they have spent minutes or longer in the autoclave and to what extent will the heat or steam destroy the structure of the filter making the items less useful,” says Grinshpun.
Grinshpun also used another decontamination method which employed soaking the respirators and surgical masks in a 70% ethanol treatment for two hours and then drying the devices before their reuse. Alcohol is readily available in hospital settings and utilized for instrument sterilization.
Tests were conducted with disinfection treatments applied up to five times to simulate reusage that might occur in a healthcare setting.
“It almost didn’t matter how often we decontaminated the protective devices– once, twice or five times — since the major damage inflicted on the performance characteristics of the items followed the first test,” explains Grinshpun. “You are going to lose in performance if these masks or respirators are sterilized using either of these treatments. Of course, quantitatively, the effect differs for different devices.”
The findings of the study are available online in the Journal of Hospital Infection. Co-authors of the study include Michael Yermakov, MD, senior research associate in the UC Department of Environmental and Public Health Sciences, and Marat Khodoun, PhD, research associate professor in the UC Department of Internal Medicine.
The study found that neither sterilization in an autoclave nor alcohol treatment caused visible damages to the surgical masks. The 3M 8210 N95 respirator revealed physical damages after implementing a single autoclave disinfection such as partial disintegration of the soft sealing material around the nose clip, and, importantly, loss of strap elasticity, which made this respiratory protective device not reusable.
Meanwhile, testing of the remaining 3M 1870 N95 respirator produced notable, but moderate damage and some detachment along with a minor deformation of the nose foam after a single and multiple autoclaving.
Experimental design of the study included testing each protective device by mounting it on a frame designed to utilize the entire effective filtration area. An air flow rate through the system was chosen to mimic breathing of a health care worker under a moderate and a strenuous workload. To simulate contamination of the test protective devices the items were soiled with protein.
“When multiple sterilizations were applied, facepieces were soiled before each autoclave treatment to mimic the device usage in air environments contaminated with protein that may be associated with emission of pathogenic virions by infected persons,” according to the study. Researchers chose to perform five soil and sterilization cycles to simulate a daily reuse of the filtering facepiece over a period of five days.
Grinshpun also says that N95 respirators and some surgical masks rely on fibers that have an electrostatic charge which allows them to capture small particles and protect the wearer. Autoclaving and alcohol treatment weaken this electrostatic charge.
“What happens when you subject something to alcohol, heat or steam?” asks Grinshpun. “These fibers will lose, maybe not entirely, but at least some of their electric charge. This has a detrimental effect on the filter performance so that these protective devices may not be able to capture aerosol participles, including coronaviruses, as efficiently anymore.”
For some N95 respirators their collection efficiency can drop below their certification level of 95% for the most penetrating particle sizes, says Grinshpun.
He adds that performance of surgical masks changes as a result of autoclaving, whether the mask is soiled or not, with the effect being more pronounced for devices which had poor initial filtration capabilities.
He says instead of using autoclaving or ethanol alcohol to disinfect face masks and N95 respirator facepieces, alternative options such as ultraviolet light may be explored. Grinshpun’s study did not look at UV primarily because the investigators intended first to examine methods that are readily available in hospitals.
“We anticipated that UV-based and probably other techniques may be almost as efficient as autoclaving and ethanol treatment in inactivating pathogens but at the same time would not damage the fibers of protective detectives so that the particle collection efficiency will not suffer,” says Grinshpun. “Similar studies can and should be conducted with alternative decontamination methods.”
“The question of how the disinfection treatments impact the performance and integrity of respiratory protective devices remains important for as long as healthcare workers have to reuse these devices due to their shortage of personal protective equipment,” says Grinshpun.
NewsMakers
Study finds low-dose eye drops successful in managing adult myopia for 24 hours
A single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness.
Groundbreaking research from the University of Houston shows that a single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness, which affects roughly one-third of U.S. adults.
Professor of Optometry Lisa Ostrin and postdoctoral researcher Barsha Lal are reporting that even one drop in the eye of low-dose atropine (0.01%–0.1%) produces clear changes in pupil size and focusing ability that persist for at least 24 hours. Importantly, they also found that the drop shows no short-term structural effects on the eye, with only temporary changes in blood flow inside the retina.
Ostrin’s latest research is published in the journal Eye and Vision. It adds to a growing body of vision research from David Berntsen, Golden-Golden Professor of Optometry at the University of Houston, who is co-leading a national $25 million NIH-funded clinical trial to delay the development of myopia in children by using the atropine drops.
Low concentration atropine is widely prescribed to slow myopia progression in children, yet its short-term retinal and choroidal effects remain incompletely understood. Ostrin’s new study evaluated short-term effects of a range of low atropine concentrations on the length of the eye, the blood vessels in the retina and the thickness of the retina and choroid, which sits just behind the retina. These are important measurements because longer eye length is associated with myopia and as it gets longer, the retina and choroid are stretched.
“These findings indicate that a single instillation of atropine does not alter axial length or retinal or choroidal thickness over 24 hours but may transiently affect superficial retinal perfusion in a time-dependent manner,” said Ostrin.
In the double-masked, randomized study, twenty healthy adults received a single instillation of either a placebo or atropine in the right eye during five separate sessions. Researchers then checked the eye structure, thickness, and length in the central retina both one-hour and 24-hours later.
“Characterizing these short-term effects is important for a better understanding of the physiological responses to atropine in clinical and research settings,” said Ostrin who previously published research results of a study investigating the short-term effects of a range of low-dose atropine concentrations on the pupils of young adults. In that study, she found similar results with a single drop of atropine inducing significant changes in the pupils.
Together, the studies indicate that atropine induces early functional and vascular effects in the eye, in the absence of structural change.
“By linking objective ocular responses with subjective visual experience, this work advances our understanding of how atropine works and supports more precise, evidence-based, and individualized approaches to myopia management,” said Ostrin.
NewsMakers
Study: Egg consumption is associated with a lower risk of Alzheimer’s Disease
Compared to never eating eggs, eating at least five eggs per week can decrease risk of Alzheimer’s.
Consumption of eggs is associated with a lower risk of being diagnosed with Alzheimer’s Disease for those 65 years and older, according to researchers at Loma Linda University Health
Eating one egg per day for at least five days a week reduces risk of Alzheimer’s by up to 27%, researchers found.
“Compared to never eating eggs, eating at least five eggs per week can decrease risk of Alzheimer’s,” said Joan Sabaté, MD, DrPH, a professor at Loma Linda University School of Public Health and the study’s principal investigator.
Even less frequent consumption of eggs significantly reduced the risk of Alzheimer’s. Researchers found that eating eggs 1 to 3 times per month had a 17% decrease in risk, while eating eggs 2 to 4 times per week had a 20% decrease in risk, Sabaté said.
The study, Egg intake and the incidence of Alzheimer’s disease in the Adventist Health Study-2 cohort linked with Medicare data, was published last week in the Journal of Nutrition.
Researchers said they embarked on the study because of a substantial knowledge gap in the relationship between modifiable dietary factors and risk of Alzheimer’s disease risk.
Eggs are known to be a source of key nutrients that support brain health. Sabaté said. Eggs provide choline, a precursor to acetylcholine and phosphatidylcholine, both of which are critical for memory and synaptic function, the study stated. Eggs also contain lutein and zeaxanthin—carotenoids that accumulate in brain tissue and are associated with improved cognitive performance and reduced oxidative stress. Eggs also contain key omega-3 fatty acids, and yolks are particularly rich in phospholipids, which constitute nearly 30% of total egg lipids and are essential for neurotransmitter receptor function.
Researchers said they studied the consumption of eggs in visible ways — such as eating eggs in various forms, like scrambled, fried, boiled, etc. — and hidden ways, such as eggs included in baked goods and packaged foods.
The cases of Alzheimer’s Disease in the Adventist Health Study 2 cohort were diagnosed by physicians, according to Medicare records, among the study population of 40,000 subjects. Eligibility was determined using the Medicare Master Beneficiary Summary Files. The average follow-up period was 15.3 years.
The team emphasized that moderate egg consumption should be part of a balanced diet.
“Research supports eggs as part of a healthy diet,” said Jisoo Oh, DrPH, MPH, an associate professor of epidemiology at Loma Linda University School of Public Health and the study’s lead author. “Seventh-day Adventists do eat a healthier diet than the general public, and we want people to focus on overall health along with this knowledge about the benefit of eggs.”
NewsMakers
Telling people they might lose motivates more than telling them they might win, research shows
How managers choose to frame problems directly influences employees’ motivation to speak up at work. For managers, this is an insightful approach for building more open and collaborative teams.
Athletes say they hate to lose more than they love to win. New research finds the same sentiment is shared in organizations.
A Virginia Tech researcher and his colleagues discovered that when managers frame work problems as a potential loss, employees are more likely to take action than when those problems are framed as potential gains. The research also revealed that when the potential loss impacts a larger group, employees are more likely to take action in the form of speaking up to a supervisor in hopes of finding a solution. The findings were recently published in the Journal of Applied Psychology.
For managers, this research suggests that framing work problems as potential losses can influence employees to speak up more.
“Employee voice occurs when suggestions are made to improve organizational functioning,” said Phil Thompson, associate professor in the Pamplin College of Business Department of Management. “From an organizational perspective, the positive outcomes of employee voice include improved performance, effectiveness, and workplace safety. From an employee level, speaking up is positively related to creativity, innovation, engagement, and ethical behavior.”
At its core, this research shows that how managers choose to frame problems directly influences employees’ motivation to speak up at work. For managers, this is an insightful approach for building more open and collaborative teams.
“When managers say, ‘If we don’t get this done, not only will you lose the $5,000 bonus, but everybody in this work group is going to lose a $5,000 bonus,’ it magnifies an employee’s motivation to act in a proactive way,” said Thompson. “This suggests that framing work problems as what will be collectively lost – compared to what can be individually lost – makes employees want to speak up more.”
Thompson was part of a research team led by Jeffery Thomas and Jonathan Booth from The London School of Economics and Mark Bolino from Oklahoma University. Together they analyzed responses from nearly 2,000 full-time employees, MBA students, and employee-supervisor pairs for their experience in situations where work problems were framed as either a gain or a loss. Across three different studies, framing something as a loss yielded employees to voice a work suggestion more.
For example, a manager dealing with a reputational crisis of their team, such as a product quality issue, can frame the problem in a way to spark helpful employee suggestions on how to resolve the issue. For example, instead of saying “if this product has great quality, our company will look really good” a manager saying “if this product is not up to quality standards, our reputation will be damaged” carries more weight for the team. When this reputational risk is shared by everyone, employees are more willing to step forward to help the problem.
In the first study, participants were asked to think about a problem at work that was significant for them. From there, they were randomly assigned to write about the potential losses or gains from that problem. They were also asked to indicate how likely they were to talk about these problems to their supervisor. Participants who reflected on their potential losses showed a 16 percent higher willingness to speak up compared to those who focused on the potential gains.
When it came to the MBA students, they read a fictional performance review scenario where a workplace problem was described. They then rated how willing they would be to speak up about that scenario if they were in the situation. One example suggested that the entire team might fall short of its goals if an issue was not addressed. This specific scenario yielded the most likelihood of speaking up 35 percent more than the scenario’s suggesting that only they would miss their goal, supporting the research’s findings that an employee is more likely to speak up when the loss impacts more people.
The third study looked at employee-supervisor pairings to understand how these relationships play out in the real world. Using pairings from across three industries, employees reported a workplace problem they encountered and their supervisor rated how often that employee spoke up on the job. While the first two studies involved hypothetical scenarios, this real-world evidence showed that employees were 8-10 times more likely to speak up when issues were framed as a potential collective loss compared with a potential collective gain.
“This research is really geared toward managers so they can facilitate and understand how and why their employees will speak up,” said Thompson. “You can talk about the issue, but it always ends in terms of how we frame things.”
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